<!--
  ========================LICENSE_START=================================
  screenit-web
  %%
  Copyright (C) 2012 - 2020 Facilitaire Samenwerking Bevolkingsonderzoek
  %%
  This program is free software: you can redistribute it and/or modify
  it under the terms of the GNU Affero General Public License as published by
  the Free Software Foundation, either version 3 of the License, or
  (at your option) any later version.
  
  This program is distributed in the hope that it will be useful,
  but WITHOUT ANY WARRANTY; without even the implied warranty of
  MERCHANTABILITY or FITNESS FOR A PARTICULAR PURPOSE.  See the
  GNU General Public License for more details.
  
  You should have received a copy of the GNU Affero General Public License
  along with this program.  If not, see <http://www.gnu.org/licenses/>.
  =========================LICENSE_END==================================
  -->
<html xmlns:wicket>
<wicket:panel>
    <fieldset wicket:id="fieldset">
        <form wicket:id="form" class="form-horizontal">
            <div>
                <div class="control-group value">
                    <div class="span6 floatleft">
                        <label class="control-label">Monster-id</label>

                        <div class="controls" wicket:id="monsterId"></div>

                    </div>
                    <label class="control-label span6 floatright"><a class="btn floatright" wicket:id="printMonsterId"><i class="icon-print"></i></a></label>
                </div>
                <hr>
                <div class="control-group value">
                    <label class="control-label">Status formulier</label>

                    <div class="controls">
                        <span class="naam" wicket:id="labformulier.status"></span> <span
                            wicket:id="labformulierLaboratoriumContainer"> in <span
                            wicket:id="labformulier.laboratorium.naam"></span></span>
                    </div>
                </div>
                <div class="control-group value">
                    <label class="control-label">Digitaal</label>

                    <div class="controls">
                        <span class="naam" wicket:id="labformulier.digitaal"></span>
                    </div>
                </div>
                <hr>
                <div class="control-group value">
                    <label class="control-label">Vervolgstap</label>

                    <div class="controls vervolgstap">
                        <div wicket:id="reedsIngeboekt"></div>
                        <div wicket:id="vervolgTekst"></div>
                    </div>
                </div>
                <hr>
                <div class="control-group value">
                    <label class="control-label">Cli&euml;nt</label>

                    <div class="controls" wicket:id="uitnodiging.screeningRonde.dossier.client.persoon.naamVolledig"></div>
                </div>
                <div class="control-group value">
                    <label class="control-label">Geboortedatum</label>

                    <div class="controls" wicket:id="uitnodiging.screeningRonde.dossier.client.persoon.geboortedatum"></div>
                </div>
                <div class="control-group value">
                    <label class="control-label">BSN</label>

                    <div class="controls" wicket:id="uitnodiging.screeningRonde.dossier.client.persoon.bsn"></div>
                </div>
                <div class="control-group value">
                    <label class="control-label">Screeningsorganisatie</label>

                    <div class="controls" wicket:id="uitnodiging.screeningRonde.dossier.client.persoon.gbaAdres.gbaGemeente.screeningOrganisatie.naam"></div>
                </div>
                <hr>
                <div class="control-group value">
                    <label class="control-label">Type monster</label>

                    <div class="controls" wicket:id="uitnodiging.monsterType"></div>
                </div>
                <wicket:enclosure wicket:id="labformulier.datumUitstrijkje">
                <div class="control-group value">
                    <label class="control-label">Datum Uitstrijkje</label>

                    <div class="controls" wicket:id="labformulier.datumUitstrijkje"></div>
                </div>
                </wicket:enclosure>
                <div class="control-group value">
                    <label class="control-label">Verzenddatum</label>

                    <div class="controls" wicket:id="verzenddatum"></div>
                </div>
                <div class="control-group">
                    <label class="control-label">Status monster</label>

                    <div class="controls">
                        <select wicket:id="monsterStatus"></select> <span wicket:id="monsterLaboratoriumContainer"><b> in <span
                            wicket:id="laboratorium.naam"></span></b></span>
                    </div>
                </div>
                <wicket:enclosure child="nietAnalyseerbaarReden">
                    <div class="control-group">
                        <label class="control-label">Reden</label>

                        <div class="controls" wicket:id="nietAnalyseerbaarReden"></div>
                    </div>
                </wicket:enclosure>
                <div class="control-group" wicket:id="monsterSignaleringenContainer">
                    <label class="control-label">Signalering</label>
                    <div class="controls">
                        <div class="checkbox" wicket:id="signaleringen"></div>
                        <label class="control-label">Overige, namelijk:</label>
                        <div class="controls">
                            <input wicket:id="overigeSignalering" class="input-large" type="text">
                        </div>
                    </div>
                </div>
                <div class="control-group value">
                    <label class="control-label">Ontvangstdatum</label>

                    <div class="controls" wicket:id="ontvangstdatum"></div>
                </div>
            </div>
            <hr>
            <div class="control-group value">
                <div class="controls">
                    <object class="pull-left" height="280" width="130" wicket:id="barcode"></object>
                </div>
            </div>
        </form>
    </fieldset>
    <div wicket:id="dialog"></div>
</wicket:panel>
</html>
